[Can health forums dedicated to breast cancer be useful to caregivers? Analysis of initial messages on the National League Against Cancer forum over a one-year period]. / Les forums de discussion dédiés au cancer du sein peuvent-ils être utiles aux soignants ? Analyse des messages initiaux du forum de la Ligue nationale contre le cancer pendant une année.

OBJECTIVES: Forums are a source of health information and exchange. They can be studied to determine patients' needs and improve caregivers' practices. The aim of this study was to identify the needs of breast cancer patients based on messages posted on a discussion forum. METHODS: Initial messages posted in 2021 on the Ligue nationale contre le cancer (LNCC) breast cancer forum were analyzed quantitatively. Message content was classified into three categories: testimonial, request for advice or request for medical opinion. The tone of the message (positive, neutral, or negative) was recorded. The temporality of the illness during which the patient expressed herself was defined. Analysis was carried out on the initial messages using the Chi2, Fisher, and Kruskal-Wallis tests, with a significance level of<0.05. RESULTS: In 2021, 640 initial messages posted on the LNCC forum dedicated to breast cancer were analyzed. Messages were posted by 312 authors, including 275 patients and 37 family members. Three main types of messages were identified: requests for medical advice (n=339), advice (n=164), and testimonials (n=137). Requests for medical advice elicited fewer responses than testimonials (P<0.001). A need for supportive care was identified in 42.8% of messages, mostly concerning social (17.3%) and psychological (13%) care. CONCLUSION: Our study revealed a need for more information especially regarding the social impact of the disease and the side-effects of treatment. The period of greatest need of information was the diagnostic waiting time. However, patients using discussion forums are not representative of all women with breast cancer and our results should not be generalized to all patients treated for breast cancer.

[What support for requests to return to the country of origin of migrant patients in a palliative situation?] / Quel accompagnement pour les demandes de retour au pays d'origine des patients migrants en situation palliative ?

Requests for return to the country of origin of palliative patients are not exceptional and cause many difficulties for caregivers. This article provides a narrative review of the literature to examine the practical difficulties in dealing with these requests and to identify ways to overcome them. The return to the country of origin requires a medical assessment of both the conditions of the trip and the coordination with the teams that will take over the care of the patient. Transportation of patients is most often possible but requires preventive and therapeutic measures. The organization of the return journey may require collaboration between the social service, families, associations, or diplomatic representations in order to carry out the administrative procedures or to finance the return project. For patients with a language barrier, this process requires the use of professional interpreters. The return to the country of origin for patients in a palliative situation requires sufficient anticipation to take place under the best conditions. Early integration of palliative care and anticipation of the cessation of specific treatments and the end of life are ways of addressing these issues.

[COVID-19 and change to home nursing care: Prospective study on 100 patients followed in CLCC]. / COVID-19 et modification des aides à domicile : étude prospective auprès de 100 patients suivis en CLCC.

BACKGROUND: During the COVID-19 epidemic, the lockdown measures were associated with professional guidelines to care for patients. We noticed that the home nursing care of some patients monitored in supportive care wards were interrupted. The aim of this study is to determine the impact of lockdown on the home nursing care of patients monitored in supportive care wards. MATERIALS AND METHODS: This observational, descriptive, monocentric, and prospective study was conducted in the supportive care wards from the 04.20 to the 05.15.2020 among 100 patients. They were asked about their home nursing care and their frequency before and after lockdown. Our study received a favorable ruling from the ethics committee of the Hôpitaux universitaires de Strasbourg. RESULTS: About two thirds of patients had experienced a change with their home nursing care. A complete interruption was observed for 40% of them and a reduction of frequency for 10% of them. Some populations were more deeply affected: patients with a performance status 3-4, women, patients living alone or patients with motor disability. The interruption of a task usually performed by a professional was observed for 49% of patients, with the task becoming incumbent on the patient or family caregivers. CONCLUSION: Our study shows a strong impact of the lockdown on the home nursing care of our patients in spite of the professional guidelines encouraging continuity of care. Our study underlines the great importance of protecting the access to care of the most vulnerable patients.